RESUMO
The oral cavity-body relationships are bi-directional: oral diseases affect the welfare and health of the individual, while diseases and conditions of organs and tissues in the human body affect oral health. The global policy of the World Health Organization is to improve oral health in the 21st century as an integral part of promoting our general health. During the recent years the knowledge of the dental profession has grown exponentially and widened its fields of interest and this has led to impressive advances at both clinical and research levels. Oral medicine, which is a recognized, licensed specialty in Israel, is a definite example that reflects this process. In the last decade residency programs in oral medicine are in the process of constant increased demand. The authors discuss this trend and comment on the need to maintain excellence in this specialty.
Assuntos
Doenças da Boca/terapia , Saúde Bucal , Medicina Bucal/organização & administração , Saúde Global , Política de Saúde , Promoção da Saúde/métodos , Humanos , Israel , Doenças da Boca/epidemiologia , Medicina Bucal/tendências , Organização Mundial da SaúdeRESUMO
Caries and periodontal disease are the most common pathologies encountered by general dental practitioners on a daily basis. Although less frequently, the oral cavity is also affected by a plethora of pathologic lesions that may represent either a local process or may be a manifestation of systemic conditions. The etiology of these lesions is diverse and ranges from congenital/ developmental, reactive, to neoplastic (benign and malignant), metabolic and hereditary. These lesions are expected to be recognized by the dental clinicians whose main concern would be to achieve a prompt and accurate microscopic diagnosis. The way to a microscopic diagnosis goes through a biopsy procedure. The principles that should guide the dental practitioner for producing a high quality, artefact-free tissue sample from the oral cavity are reviewed in the article together with notes on errors that should be avoided. The patient's life can sometimes depend on a tissue sample as small as 0.5 cm, hence the utmost importance of the strategic and technique-related considerations to be taken by the general dental practitioner prior to performing a biopsy from the oral cavity. In certain cases, the dental practitioner should use the services of specialists in oral medicine or oral and maxillofacial surgery in order to proceed with the biopsy procedure and get a prompt and accurate diagnosis.
Assuntos
Biópsia/métodos , Doenças da Boca/diagnóstico , Neoplasias Bucais/diagnóstico , Odontólogos/organização & administração , Humanos , Microscopia/métodos , Doenças da Boca/patologia , Neoplasias Bucais/patologia , EspecializaçãoRESUMO
Zoster (shingles) is assumed to affect 10-20% of the individuals who have been exposed to the varicella zoster virus (VZV). It is expected to develop among the elderly, usually on the background of a weakened immune system. In those cases that the trigeminal branches are involved by zoster, unilateral mucosal and cutaneous vesiculo-ulcerative lesions will develop. Intense pain usually precedes the overt lesions of zoster, which sometimes might mimic acute pain of dental origin. Careful anamnesis and thorough clinical examination should lead to a correct diagnosis. Since zoster, in general, is associated with serious morbidity, including post-herpetic neuralgia, ocular damage and hearing deficits, the Centers for Disease Control and Prevention (CDC) currently recommend shingles vaccination, especially for those who are > 60-year old.
Assuntos
Dor Aguda/etiologia , Herpes Zoster/diagnóstico , Doenças da Boca/diagnóstico , Feminino , Herpes Zoster/virologia , Herpesvirus Humano 3/isolamento & purificação , Humanos , Pessoa de Meia-Idade , Doenças da Boca/virologiaRESUMO
OBJECTIVE: To evaluate the distribution of oral and maxillofacial pathologies (OMFPs) and its association with patient age in young- and middle-aged adults. METHODS: Distribution of histopathologically diagnosed OMFPs (n = 385) treated during 2007-2010 was recorded and the association with patient age was retrospectively analyzed. RESULTS: The main diagnostic categories included benign exophytic lesions (45.3%), white benign lesions (13.5%), potentially malignant lesions/disorders (10.1%), intrabony lesions (9.8%), mucosal discoloration (7.8%), benign pigmented lesions (7.3%), chronic trauma/inflammation (3.9%), and oral malignancy (2.1%). Potentially malignant lesions/disorders as a diagnostic category were positively associated with age (OR = 1.07 for 1 year; P < 0.001) and specifically the diagnoses of oral lichen planus (OR = 1.04 for 1 year; P = 0.037) and dysplastic changes (OR = 1.08 for 1 year; P = 0.013) that comprised this category. Pigmented melanocytic lesions were negatively associated with age (OR = 0.94 for 1 year; P = 0.039) as well as benign/reactive exophytic lesions (OR = 0.98 for 1 year; P = 0.038), the latter included the histopathological diagnosis of benign salivary gland pathologies (OR = 0.90 for 1 year; P < 0.001). CONCLUSION: This study provided baseline information regarding the distribution OMFPs among young- and middle-aged adults. It is important to highlight the high frequency of potentially malignant lesions/disorders and oral malignancy in young- and middle-aged adults, as these lesions require lifelong follow-up.
Assuntos
Doenças da Boca/epidemiologia , Adolescente , Adulto , Biópsia , Feminino , Humanos , Israel/epidemiologia , Pessoa de Meia-Idade , Doenças da Boca/diagnóstico , Doenças da Boca/patologia , Patologia Bucal , Estudos Retrospectivos , Fatores de Risco , Glândulas Salivares/patologia , Adulto JovemRESUMO
Most digital imaging systems provide opportunities for image enhancement operations. These are applied to improve the original image and to make the image more appealing visually. One possible means of enhancing digital radiographic image is sharpening. The purpose of sharpening filters is to improve image quality by removing noise or edge enhancement. Sharpening filters may make the radiographic images subjectively more appealing. But during this process, important radiographic features may disappear while artifacts that simulate pathological process might be generated. Therefore, it is of utmost importance for dentists to be familiar with and aware of the use of image enhancement operations, provided by medical digital imaging programs.
Assuntos
Intensificação de Imagem Radiográfica/métodos , Radiografia Dentária Digital/métodos , Artefatos , HumanosRESUMO
This short communication is aimed to update dental practitioners regarding the recently published warning of the U.S. Food and Drug Administration (FDA) regarding the risk for severe cardiovascular complications such as myocardial infarction or stroke following the use of non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs).
Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Infarto do Miocárdio/induzido quimicamente , Acidente Vascular Cerebral/induzido quimicamente , Odontólogos , Humanos , Risco , Estados Unidos , United States Food and Drug AdministrationRESUMO
Most digital systems that are currently used in two-dimensional imaging in dentistry provide opportunities for different image processing filters. One possible means of enhancing digital radiographic image is pseudocoloring (i.e., color conversion of gray-scale images). Recently, this method has become widely used in digital radiology. The human eye is more sensitive to differences in color than to differences in shades of gray. Theoretically, converting a gray scale intensity level of a digital image into colors could enhance the radiographic information. There have been some studies that applied pseudocoloring of digital radiographic images for the detection of caries and periodontal defects. However, thus far, this method failed to show a significantly improved ability for the detection of these lesions. Further investigations are necessary in order to develop specific algorithms that will increase the validity of pseudocoloring in two-dimensional imaging in dentistry.
Assuntos
Intensificação de Imagem Radiográfica/métodos , Radiografia Dentária Digital/métodos , Cor , Cárie Dentária/diagnóstico , Humanos , Intensificação de Imagem Radiográfica/instrumentação , Radiografia Dentária Digital/instrumentaçãoRESUMO
Head and neck squamous cell carcinoma (HNSCC), the eighth most common cancer worldwide, accounts for approximately 600,000 new cases per year. The mobile tongue is the most common site for oral cancer and is associated with a poorer survival than other HNSCC sites. Standard therapeutic strategies have failed to significantly improve survival rates that have remained around 50% over the past four decades. In the last decade intense investigations on oral cancer highlighted the mandatory role of the tumor microenvironment (TME), in addition to the genetic aberrations and molecular biology changes within the cancer cells. Furthermore, the molecular crosstalk between cancer cells and TME components (i.e., cancer-associated fibroblasts, inflammatory pro-tumorigenic cells, etc.) has a crucial role in growth, invasion, spread and metastases of the cancer cells and consequently leads to poor prognosis. Recent studies suggest that plant-derived dietary agents nutraceuticals, especially curcumin and green tea, have the advantage to combat both malignant cells and TME components, unlike standard anti-cancer protocols that target only cancer cells. However, due to a very low bioavailability, nutraceuticals do not currently constitute an integral part of these protocols. Ongoing developments in nanotechnology for improved delivery are expected to overcome their challenging pharmacokinetics.
Assuntos
Carcinoma de Células Escamosas/tratamento farmacológico , Suplementos Nutricionais , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias Bucais/tratamento farmacológico , Antineoplásicos/uso terapêutico , Carcinoma de Células Escamosas/patologia , Curcumina/uso terapêutico , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Neoplasias Bucais/patologia , Nanotecnologia/métodos , Prognóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço , Taxa de Sobrevida , Chá/química , Microambiente TumoralRESUMO
AIM: To establish whether eliminating Lysyl oxidase (LOX) gene would affect dentine formation. METHODOLOGY: Newborn wild-type (wt) and homo- and heterozygous LOX knock-out (Lox(-/-) and Lox(+/-) , respectively) mice were used to study developing tooth morphology and dentine formation. Collagen aggregation in the developing dentine was examined histochemically with picrosirius red (PSR) staining followed by polarized microscopy. Because Lox(-/-) die at birth, adult wt and Lox(+/-) mouse tooth morphologies were examined with FESEM. Human odontoblasts and pulp tissue were used to study the expression of LOX and its isoenzymes with Affymetrix cDNA microarray. RESULTS: No differences between Lox(-/-) , Lox(+/-) and wt mice developing tooth morphology were seen by light microscopy. Histochemically, however, teeth in wt mice demonstrated yellow-orange and orange-red polarization colours with PSR staining, indicating thick and more densely packed collagen fibres, whilst in Lox(-/-) and Lox(+/-) mice, most of the polarization colours were green to green-yellow, indicating thinner, less aggregated collagen fibres. Fully developed teeth did not show any differences between Lox(+/-) and wt mice with FESEM. Human odontoblasts expressed LOX and three of four of its isoenzymes. CONCLUSIONS: The data indicate that LOX is not essential in dentinogenesis, even though LOX deletion may affect dentine matrix collagen thickness and packing. The absence of functional LOX may be compensated by LOX isoenzymes.
Assuntos
Dentinogênese/fisiologia , Proteínas da Matriz Extracelular/análise , Proteína-Lisina 6-Oxidase/análise , Amelogênese/genética , Amelogênese/fisiologia , Animais , Animais Recém-Nascidos , Compostos Azo , Colágeno/ultraestrutura , Corantes , Polpa Dentária/enzimologia , Dentina/ultraestrutura , Dentinogênese/genética , Proteínas da Matriz Extracelular/genética , Proteínas da Matriz Extracelular/fisiologia , Regulação Enzimológica da Expressão Gênica , Heterozigoto , Homozigoto , Humanos , Isoenzimas/análise , Isoenzimas/fisiologia , Camundongos , Camundongos Knockout , Microscopia Eletrônica de Varredura , Microscopia de Polarização , Odontoblastos/enzimologia , Odontogênese/genética , Odontogênese/fisiologia , Análise de Sequência com Séries de Oligonucleotídeos , Proteína-Lisina 6-Oxidase/genética , Proteína-Lisina 6-Oxidase/fisiologiaRESUMO
Magnetic resonance imaging (MRI) is an integral part of the evaluation of local and regional disease in tongue squamous cell carcinoma prior to surgery. The aim of this study was to evaluate the accuracy of MRI in assessing tumour dimensions, as well as the impact of the time-lag from diagnostic biopsy on the accuracy of MRI. The medical records of 64 patients with tongue carcinoma were reviewed retrospectively. Tumour maximum diameter and tumour depth of invasion were compared between pathology and MRI (T1- and T2-weighted). MRI-derived maximum tumour diameter and depth of invasion correlated strongly with histopathology: T1-weighted (r = 0.700 and r = 0.813, respectively) and T2-weighted (r = 0.734 and r = 0.834, respectively). A significant correlation was found between measurements on T1 and T2 MRI for both parameters (P = 0.955 and P = 0.984, respectively). The accuracy rate of MRI for T-staging of early tumours was low: 10% for T1 tumours; 39.3% for T2 tumours. A time-lag of less than 2 weeks between the diagnostic biopsy and MRI adversely affected the correlation of tumour dimensions. MRI is a reliable tool for evaluating tongue carcinoma; however, it overestimates early tumours. A 2-week delay after diagnostic biopsy is desired before completing an MRI. Alternatively, if logistics allow, a pre-biopsy MRI is preferred, especially for T1-T2 tumours.
Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias da Língua , Humanos , Neoplasias da Língua/diagnóstico por imagem , Neoplasias da Língua/cirurgia , Neoplasias da Língua/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/patologia , Estudos Retrospectivos , Estadiamento de Neoplasias , Imageamento por Ressonância Magnética/métodos , Neoplasias de Cabeça e Pescoço/patologiaRESUMO
OBJECTIVES: To present a combination of clinical and histopathological criteria for diagnosing cheilitis glandularis (CG), and to evaluate the association between CG and squamous cell carcinoma (SCC). MATERIALS AND METHODS: The medical literature in English was searched from 1950 to 2010 and selected demographic data, and clinical and histopathological features of CG were retrieved and analysed. RESULTS: A total of 77 cases have been published and four new cases were added to the collective data. The clinical criteria applied included the coexistence of multiple lesions and mucoid/purulent discharge, while the histopathological criteria included two or more of the following findings: sialectasia, chronic inflammation, mucous/oncocytic metaplasia and mucin in ducts. Only 47 (58.0%) cases involving patients with a mean age of 48.5 ± 20.3 years and a male-to-female ratio of 2.9:1 fulfilled the criteria. The lower lip alone was most commonly affected (70.2%). CG was associated with SCC in only three cases (3.5%) for which there was a clear aetiological factor for the malignancy. CONCLUSIONS: The proposed diagnostic criteria can assist in delineating true CG from a variety of lesions with a comparable clinical/histopathological presentation. CG in association with premalignant/malignant epithelial changes of the lower lip may represent secondary, reactive changes of the salivary glands.
Assuntos
Doenças Labiais/diagnóstico , Glândulas Salivares Menores/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/diagnóstico , Queilite/diagnóstico , Queilite/patologia , Criança , Pré-Escolar , Diagnóstico Diferencial , Dilatação Patológica/patologia , Feminino , Humanos , Doenças Labiais/patologia , Neoplasias Labiais/diagnóstico , Masculino , Metaplasia , Pessoa de Meia-Idade , Mucinas/análise , Células Oxífilas/patologia , Neoplasias das Glândulas Salivares/diagnóstico , Sialadenite/diagnóstico , Sialadenite/patologia , Supuração , Adulto JovemRESUMO
BACKGROUND: The aggressive biological behavior of odontogenic keratocysts (OKCs), unlike that of other odontogenic cysts, has argued for its recent re-classification as a neoplasm, 'keratocystic odontogenic tumor'. Identification of mutations in the PTCH gene in some of the OKCs that were expected to produce truncated proteins, resulting in loss of control of the cell cycle, provided additional support for OKCs having a neoplastic nature. METHODS: We investigated the immunohistochemical expression of the sonic hedgehog (SHH) signaling pathway-related proteins, PTCH, smoothened (SMO) and GLI-1, and of the SHH-induced bcl-2 oncoprotein in a series of primary OKC (pOKC), recurrent OKC (rOKC) and nevoid basal cell carcinoma syndrome-associated OKCs (NBCCS-OKCs), and compared them to solid ameloblastomas (SAMs), unicystic ameloblastomas (UAMs), 'orthokeratinized' OKCs (oOKCs), dentigerous cysts (DCs) and radicular cysts (RCs). RESULTS: All studied lesions expressed the SHH pathway-related proteins in a similar pattern. The expression of bcl-2 in OKCs (pOKCs and NBCCS-OKCs) and SAMs was significantly higher than in oOKCs, DCs and RCs (P < 0.001). CONCLUSIONS: The present results of the immunoprofile of OKCs (that includes the expression of the SHH-related proteins and the SHH-induced bcl-2 oncoprotein) further support the notion of OKC having a neoplastic nature. As OKCs vary considerably in their biologic behavior, it is suggested that the quality and quantity of interactions between the SHH and other cell cycle regulatory pathways are likely to work synergistically to define the individual phenotype and corresponding biological behavior of this lesion.
Assuntos
Proteínas Hedgehog/metabolismo , Neoplasias Maxilomandibulares/metabolismo , Cistos Odontogênicos/metabolismo , Receptores de Superfície Celular/metabolismo , Receptores Acoplados a Proteínas G/metabolismo , Fatores de Transcrição/metabolismo , Ameloblastoma/imunologia , Ameloblastoma/metabolismo , Ameloblastoma/patologia , Análise de Variância , Síndrome do Nevo Basocelular/imunologia , Síndrome do Nevo Basocelular/metabolismo , Síndrome do Nevo Basocelular/patologia , Estudos de Casos e Controles , Regulação Neoplásica da Expressão Gênica/fisiologia , Humanos , Imuno-Histoquímica , Doenças Maxilomandibulares/imunologia , Doenças Maxilomandibulares/metabolismo , Doenças Maxilomandibulares/patologia , Neoplasias Maxilomandibulares/classificação , Neoplasias Maxilomandibulares/imunologia , Neoplasias Maxilomandibulares/patologia , Cistos Odontogênicos/imunologia , Cistos Odontogênicos/patologia , Receptores Patched , Receptor Patched-1 , Proteínas Proto-Oncogênicas c-bcl-2/genética , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Receptores de Superfície Celular/genética , Receptores Acoplados a Proteínas G/genética , Valores de Referência , Sistemas do Segundo Mensageiro/fisiologia , Transdução de Sinais/fisiologia , Receptor Smoothened , Fatores de Transcrição/genética , Proteína GLI1 em Dedos de ZincoRESUMO
Aggressive cases of central giant cell granuloma (CGCG) have been arbitrarily treated with steroids and calcitonin. The aim of this study was to develop a practical tool, based on the relative percentage of positively stained cells for glucocorticoid and/or calcitonin receptors, for selecting the appropriate therapeutic agents to treat CGCG. Forty-one formalin-fixed, paraffin-embedded blocks of CGCG were immunohistochemically stained for glucocorticoid and calcitonin receptors. Percentage of positive lesional mononuclear and giant cells was estimated for each case. Intense staining was considered as staining 50% or more of the cells. Correlations among staining scores were analysed by Spearman's test. All cases stained for glucocorticoid receptor. Heterogeneity among cases showed as intense staining in both cell types (21 lesions), in only one cell type (13 lesions) and weakly in both cell types (7 lesions). Only 23 cases demonstrated staining for calcitonin receptor, of which 15 stained intensely in both cell types and 7 in only one cell type. Among staining scores of both receptors, no significant statistical correlation was found (P>0.05). It can therefore be suggested that the relative percentage of immunohistochemically stained mononuclear and giant cells for glucocorticoid and/or calcitonin receptors can serve as a reliable and practical tool for selecting the appropriate therapeutic agent to treat CGCG. The clinical application of this method should be assessed in well controlled clinical studies, especially in cases of aggressive lesions, before initiating and during therapeutic treatment.
Assuntos
Granuloma de Células Gigantes/metabolismo , Doenças Maxilomandibulares/metabolismo , Receptores da Calcitonina/análise , Receptores de Glucocorticoides/análise , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Antineoplásicos/uso terapêutico , Calcitonina/uso terapêutico , Criança , Pré-Escolar , Feminino , Granuloma de Células Gigantes/tratamento farmacológico , Humanos , Doenças Maxilomandibulares/tratamento farmacológico , Masculino , Camundongos , Pessoa de Meia-Idade , Coelhos , Estatísticas não Paramétricas , Esteroides/uso terapêuticoRESUMO
PURPOSE: To evaluate histomorphometric age-related changes in labial salivary glands (LSG) of healthy subjects, with special reference to the mucous and seromucous acini. METHOD: Investigation of age-related histomorphometric changes was conducted on 120 samples of LSG obtained from autopsy subjects free of salivary gland tumors/diseases. Samples were divided into young (< 30 years, n = 30), adult (30-60 years, n = 45) and old (> 60 years, n = 45) age groups. Measurements were performed on hematoxylin and eosin stained slides. Parenchymal components included acini and ducts. The acinar component was presently analyzed separately in respect to mucous acinar cells and seromucous acinar cells. Mucous acinar cells presented pale eosinophilic cytoplasm, while that of the seromucous was darker and basophilic. Stromal components included connective tissue, blood and lymphatic vessels, inflammatory infiltrate and adipose tissue. The mean volume fraction (V(v)) of all components in each age group was calculated. Statistical analysis was performed by one-way ANOVA and Tamhane tests. RESULTS: The mean V(v) of the seromucous acinar cells decreased by 49.3% (p < 0.0001) and that of the mucous acinar cells decreased only by 28.5% (p = 0.0001). Changes in the ducts were statistically non-significant (p = 0.312). Of the stromal components, the mean V(v) of the adipose tissue showed the highest increase, 2768% (p < 0.0001) followed by the inflammatory infiltrate, 512% (p < 0.0001). CONCLUSIONS: The marked decrease in the V(v) of seromucous acinar cells accompanied by a lower decrease in the V(v) of mucous acinar cells may explain age-related changes in LSG secretion. These findings could bear important implications regarding functional age-related changes of these glands.
Assuntos
Envelhecimento/patologia , Glândulas Salivares/anatomia & histologia , Adulto , Idoso , Envelhecimento/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Glândulas Salivares/citologia , Glândulas Salivares/fisiologiaRESUMO
The aim of the present study was to examine age-related changes in the parenchymal and stromal components of palatal salivary glands of healthy subjects. Palatal salivary gland biopsies were obtained from 120 autopsies and were divided into young, adult, and old age groups. Histomorphometric measurements were performed on hematoxylin and eosin (H&E) stained slides. Parenchymal components included acini and ducts, and stromal components included connective tissue, blood and lymphatic vessels, inflammatory infiltrate, and adipose tissue. The mean volume fraction of each component in each age group was calculated. Statistical analysis was performed by one-way ANOVA and Tamhane tests. The mean volume fraction of the acinar component demonstrated a significant age-related decrease of 48% (P < 0.001). The mean volume fractions of the ducts and of all the stromal components demonstrated a significant age-related increase (P < 0. 001). The inflammatory infiltrate component had the highest increase with aging (1471%), followed by the ducts (177%), blood and lymphatic vessels (138%), adipose tissue (130%), and connective tissue (60%). These age-related changes, the first to be reported in palatal salivary glands from healthy subjects, are different from those described in the labial salivary glands, especially in regard to the significant increase in the parenchymal ductal component, as well as in the stromal inflammatory infiltrate and adipose tissue components. It can be suggested that these changes could have important implications regarding the age-related function of these glands.
Assuntos
Envelhecimento/patologia , Glândulas Salivares/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Oral mucositis (OM), an inevitable side effect of almost all anti-cancer treatments, affects the patient's physiological functions and their psychological well being. In spite of numerous treatment modalities for this condition, there is still a lack of evidence-based clinical trials that can provide a single efficient pharmacologic agent or intervention for either prevention or treatment of OM. This study analyses and summarizes some of the more "accepted" modalities for treatment of OM. It is recommended that these modalities rely on simple, convenient and innocuous interventions, which should be adjusted for each individual complaint. Well-designed, controlled and standardized studies are necessary to validate effectiveness of available, as well as newly developed interventions for OM.
Assuntos
Antineoplásicos/efeitos adversos , Radioterapia/efeitos adversos , Estomatite/terapia , Anti-Infecciosos Locais/uso terapêutico , Protocolos Clínicos , Assistência Odontológica , Comportamento Alimentar , Humanos , Antissépticos Bucais/uso terapêutico , Lesões por Radiação/prevenção & controle , Lesões por Radiação/terapia , Estomatite/etiologia , Estomatite/prevenção & controleRESUMO
The malignant potential of oral lichen planus (OLP) has been a matter of serious controversy. We aimed to detect chromosomal numerical aberrations in cells of brush samples collected from affected mucosa. The samples were simultaneously analyzed for morphology and fluorescent in situ hybridization (FISH) with chromosomes 2 and 8 centromeric probes. We analyzed 57 persons with OLP and 33 control individuals. A cut-off value of aneuploid cells was determined as 1.1%. Aneuploid cells were found in 16 persons with OLP (28.1%); in 10 individuals (17.5%), over 5% of the cells were aneuploid. Aneuploid cells were also detected in normal-looking mucosa of seven persons with OLP. One person with OLP developed squamous cell carcinoma; 10% of the cells examined were aneuploid. OLP carries an increased risk for chromosomal instability. Identifying aneuploid cells in a brush sample and the combined morphological and FISH analysis can increase the specificity in predicting the malignant potential of OLP.